Computer modelling of neural tube defects

Neurulation, the curling of the neuroepithelium to form the neural tube, is an essential component of the development of animal embryos. Defects of neural tube formation, which occur with an overall frequency of one in 500 human births, are the cause of severe and distressing congenital abnormalities. However, despite the fact that there is increasing information from animal experiments about the mechanisms which effect neural tube formation, much less is known about the fundamental causes of neural tube defects (NTD). The use of computer models provides one way of gaining clues about the ways in which neurulation may be compromised. Here we employ one computer model to examine the robustness of different cellular mechanisms which are thought to contribute to neurulation. The model, modified from that of Odell et al (Odell, G.M., Oster, G., Alberch, P. and Burnside, B., (1981)) mimics neurulation by laterally propagating a wave of apical contraction along an active zone within a ring of cells. We link the results to experimental evidence gained from studies of embryos in which neurulation has been perturbed. The results indicate that alteration of one of the properties of non-neural tissue can delay or inhibit neurulation, supporting the idea, gained from observation of embryos bearing genes which predispose to NTD, that the tissue underlying the neuroepithelium may contribute to the elevation of the neural folds. The results also show that reduction of the contractile properties of a small proportion of the neuroepithelial cell population may have a profound effect on overall tissue profiling. The results suggest that the elevation of the neural folds, and hence successful neurulation, may be vulnerable to relatively minor deficiencies in cell properties.

Development of anencephaly and its variants

Extreme variants of anencephaly in two human embryos of the same stage, namely 22 (54 days), shed new light on problems such as craniocerebral interrelationships and the timing of developmental events. Embryo X had a chondrocranium that possessed features typical of a holoacranial anencephalic skull and an extremely well-preserved brain, in which some of the neural tracts were comparable to those in a normal control. On the other hand, embryo Y of the same stage had a completely degenerated brain, although the chondrocranium was more nearly normal and represented the precursor of a meroacranial skull. A comparison of the two cases seems to indicate a certain independence between skull and brain. Moreover, it appears possible that the disturbances are related primarily to the skeletal, and only secondarily to the nervous, component. Comparisons with experimental data allow the conclusion that the maldevelopment involves mostly paraxial mesenchyme and little or no disturbance of neural crest. The timing of the mesenchymal defect is probably as early as stages 8 and 9 (18-20 days). This is also the time at which mesenchymal defects can result in failure of the neural tube to close.

Effects of retinoic acid on chick tail bud development

The present study describes the teratogenic effects of retinoic acid (RA) on the development of the chick tail bud. Chick embryos were recovered 48 hours after treatment at HH stages 11 to 16 with various dosages of RA by subblastodermal injection. At the gross level, RA treatment resulted in varying degrees of caudal regression, scoliosis, limb malformations, and open posterior neuropores among the survivors. Histological examination of tail buds from treated embryos revealed defects which included total dysplasia of caudal structures, the presence of accessory neural tube and notochord tissue, and abnormal fusions of the notochord to the neural tube and tailgut. The incidence, severity, and location of the defects were dependent on the dose of the teratogen, and the stage of development at the time of treatment. The defects resembled those induced in previous studies by treatment with sialic acid binding lectins such as wheat germ agglutinin and limulus polyphemus lectin (Griffith and Wiley, '90b).

Studies of the effect of retinoic acid on anterior neural tube closure in mice genetically liable to exencephaly

Previously we have shown that all SELH/Bc mouse embryos close their anterior neural tubes by an abnormal mechanism and that 10-20% of SELH/Bc embryos are exencephalic. The purposes of these studies were (1) to observe the effects of retinoic acid on the frequency of exencephaly in SELH/Bc embryos; (2) to compare the SELH/Bc response with those of normal strains and of other neural tube mutants; and (3) to compare, between SELH/Bc and a normal strain (SWV/Bc), the effects of retinoic acid on morphology of the closing anterior neural tube. SELH/Bc was more liable to retinoic acid-induced exencephaly than were normal strains. After maternal treatment with 5 mg/kg retinoic acid on day 8.5 of gestation, 53% of SELH/Bc embryos had exencephaly, compared with 22% in ICR/Bc and 14% in SWV/Bc. When these results were transformed according to the assumptions of the developmental threshold model, the effects of genotype and retinoic acid appeared to be additive. Similar treatment on day 9 or 10 of gestation had little or no effect on the frequency of exencephaly in SELH/Bc mice. These results are similar to the reported responses of the curly-tail and Splotch mutants, where frequencies of spina bifida but not exencephaly were decreased. This pattern suggests that studies of effects of periconceptional vitamin treatment on risk of human neural tube defects should consider anencephaly and spina bifida separately. The study comparing the morphology of anterior neural tube closure in SELH/Bc and normal SWV/Bc embryos showed that retinoic acid delays the elevation of the mesencephalic neural folds. This results in a "stalling" of many embryos in the first steps of neural tube closure, with their neural folds remaining convex and splayed wide apart. The delay in fold elevation was superimposed on the different closure patterns of the two strains. The overall conclusion is that there is no nonadditive interaction in the parameters studied between retinoic acid treatment and the SELH/Bc genotype.

Spina bifida: a chick embryo experimental model

Neural Tube Defects (NTD) can be induced in the chick embryo with relative ease in order to provide an experimental tool for investigation of such disabling malformations. Domestic hen (Gallus gallus) eggs were incubated at 37.5 degrees C and 80% humidity for 24 h. At that moment, 5 ml of albumen were aspirated by sterile puncture of the shell, and the incubation was resumed. The embryos were recovered and studied at the 8th, 10th and 14th days. Almost half (45%) of the 602 treated embryos survived and 73 of them (12%) had various malformations. Thirty-six (6%) suffered NTD of which 30 were open myelomeningocele, 2 meningocele and 4 encephalocele. The anatomy of the defects was astonishingly similar to that of the human malformation. Whether these experimental NTD are induced by mechanical or nutritional modifications of the internal environment of the egg is unknown, but the similarity of the lesion with those in humans make them suitable for further investigation of these issues. We believe that this relatively simple and inexpensive model is a suitable tool for research on spina bifida.

The pattern of neural tube defects created by secondary reopening of the neural tube

The usual location of human neural tube defects at the rostral or caudal end of the primary neural tube suggests they are caused by failure of closure of the neural tube. In this study, neural tube defects were created by surgical reopening of the neural tube of 3-day-old duck embryos in one of three sites: the forebrain, cervicothoracic region, or thoracolumbar region. It was determined that of the 31 survivors with forebrain incisions, 39% had exencephaly; of the 42 survivors with thoracolumbar incisions, 31% had myeloschisis; but of the 37 with a cervicothoracic incision, only 14% had exposed spinal cord. This indicates that a rostral-caudal distribution of neural tube defects can be seen in a model created by secondary reopening of the neural tube.

All-or-none craniorachischisis in Loop-tail mutant mouse chimeras

Mouse embryos homozygous for the mutant gene Loop-tail (Lp) are characterized by craniorachischisis, an open neural tube extending from the midbrain to the tail. In the present study, experimental chimeric mice containing mixtures of genetically mutant (from Lp/+ × Lp/+ matings) and genetically normal cells were produced. Our aim was to determine whether a ‘rescue,’ phenotypic gradient, or intermediate expression (i.e. alternating areas of open and closed neural tube) would be observed in these chimeras. We report our analyses of Loop-tail mutant chimeras (n = 82) by gross examination, progeny testing and quantitative analysis of glucose phosphate isomerase (GPI) isozyme levels. An all-or-none craniorachischisis in Loop-tail mutant chimeras was observed. Two multicolored adult chimeras, without any gross evidence of a neural tube defect, were shown to be homozygous Loop-tail chimeras (Lp/Lp in equilibrium +/+) by progeny testing. These results indicate that the normal phenotype can be expressed in the presence of mutant cells. Conversely, six neonates with craniorachischisis were shown to be chimeras by GPI analyses. These results show that the full mutant phenotype can be expressed even when one-third to one-half of the cells are genotypically wild-type. This study did not determine which tissue is primarily responsible for the defective neurulation in this mutant, but suggests that a ‘threshold’ mechanism underlies the Loop-tail mutant phenotype. In some chimeras that threshold is not reached and the neural tube remains open, whereas in other chimeras the threshold is reached and the neural tube closes completely.

The paralysis associated with myelomeningocele: clinical and experimental data implicating a preventable spinal cord injury

Paralysis seen in children with myelomeningocele has been attributed to congenital myelodysplasia. We suspected that paralysis may be due in part to a spinal cord injury caused by exposure of the neural tube to the amniotic fluid. This hypothesis was tested using a fetal rat model of surgically created dysraphism. Each pup from the experimental group of rats in which the spinal cord was intentionally exposed to the amniotic fluid was born with severe deformity and weakness of the hind limbs and tail. Control fetal rats, subjected to the same procedure without directly exposing the spinal cord to the intrauterine environment, were normal at birth. Histological studies of the exposed spinal cord revealed extensive erosion and necrosis, findings similar to those described in children with myelomeningocele. We therefore propose a "two-hit" hypothesis to explain the paralysis seen in children with myelomeningocele: congenital myelodysplasia complicated by an intrauterine spinal cord injury. Intrauterine protection of the exposed spinal cord might prevent some or all of the paralysis. The possible implications of these findings for the future treatment of myelomeningocele are discussed.

Facial dysmorphologic and skeletal cephalometric findings associated with conotruncal cardiac anomalies. off

Anomalous conotruncal cardiac morphology and facial dysmorphology have been associated with neural crest-pharyngeal arch abnormalities. To assess these associations, 20 patients 3 to 18 years old with tetralogy of Fallot (TOF) or persistent truncus arteriosus (PTA) were evaluated by cardiologic, facial dysmorphic, and cephalometric criteria. The average number of facial abnormalities of neural crest derivation was two, while pharyngeal arch derivative abnormalities were observed with an average of five defects per subject. The total group had many more facial malformations than normal populations (P less than .00001). The occurrence of defects was not significantly different between TOF and PTA patients. Thirteen TOF patients 8 years, 9 months to 18 years, 10 months old (x = 13 years, 4 months) had lateral cephalograms analyzed for skeletal relationships. The TOF patients exhibited higher than usual distribution of dolichofacial growth patterns (6 of 13), Class II skeletal relationships (6 of 13), mandibular retrusion (7 of 13), and maxillary protrusion (6 of 13). Trends were not absolute, since opposite patterns were individually expressed, and referencing by race tended to show more normal values for respective groups.

The neurocristopathies: reinterpretation based upon the mechanism of abnormal morphogenesis

This review sets forth a broadened interpretation of the neurocristopathies based on the current understanding of the role of neural crest cells in normal development. Two general types of cristopathies are defined predicated on the abnormal mechanism involved in production of the defect or condition. Defects and disorders which constitute the originally defined neurocristopathies including pheochromocytoma, neurofibromatosis, and the multiple endocrine adenomatoses are best explained as dysplasias of neural crest derivatives. Affected individuals rarely exhibit true malformation of structure but do carry a lifetime risk for disordered growth of crest derived tissue. On the other hand, defects and disorders which derive from migrational abnormalities primarily of cranial neural crest cells such as frontonasal dysplasia, the DiGeorge sequence, and Waardenberg syndrome represent true malformations. The spectrum of involvement is usually definable at the time of diagnosis and disordered growth of crest derived tissue does not occur. The clinical implications of this distinction are discussed.

Variation in the response of chick embryos to incision of the roof plate of the neural tube at different developmental stages

The effects of microsurgical reopening of the neural tube were examined in chick embryos of Stages 12-18. The roof plate of the thoracic neural tube was incised for a length equivalent to 7 somites. The site of incision was studied histologically and by SEM and TEM at intervals up to 48 hours. 48 hours after operation, persistent neural tube defects were more frequent and longer in embryos of more advanced stages at operation. Exposure of embryos to Streptomyces hyaluronidase, which inhibits neurulation in normal embryos, has no effect on the healing of the incised neural tube in the young embryos. Healing of the lesion in younger embryos appeared to occur in two stages: initially, by repair of the surface ectoderm, by a cephalo-caudal zipper-like mechanism, followed by a reconstitution of the roof plate by migration of neurectodermal cells on the deep surface of the ectoderm. Neural tubes of older embryos splay open more widely on incision of the roof plate, apparently making healing mechanically more difficult. This wider splaying may be related to the decline of forces which maintain occlusion of the neural canal in younger embryos.

Characterization of rapidly adhering amniotic fluid cells by combined immunofluorescence and phagocytosis assays

Culture of human amniotic-fluid cells from cases of fetal neural tube defects produces a population of rapidly adhering cells that were initially thought to be macrophages and later interpreted to be of neural origin. In this study double and triple labeling systems for the simultaneous detection of glial and macrophage differentiation marker antigens have been used to demonstrate that rapidly adhering cells cannot be considered a homogeneous population but instead represent two distinct cell types. One of these cell populations is of glial origin and shows specific staining for glial fibrillary acidic protein, while the other population is monocyte-derived macrophages which express marker antigens recognized by Leu M3, KiM7, and Dako antimacrophage monoclonal antibodies.

Maternal fertility, reproductive loss, and defective human embryos

It is possible that many abnormal conceptuses are lost at an early stage without the mother's knowledge. To investigate this further the reproductive history of the mothers of defective embryos (neural tube defects, holoprosencephaly, cleft lip, polydactyly, and early embryonic resorption) was compared with that of the mothers of normal embryos. The frequency of prior miscarriages was higher in the case mothers than in normal controls matched for maternal age and gravidity, the difference being significant for all the anomalies except for polydactyly. The case mothers had fewer prior recognised pregnancies than control mothers matched for maternal age. There were more primigravid mothers in abnormal groups, and the difference from controls was significant for neural tube defects. It was assumed that the gravidity of the case mothers may be underestimated, possibly due to increased early abortions which are not recognised clinically. Thus, it seems that both recognised and unrecognised abortions occur more often in the mothers of defective embryos. Since many spontaneous abortuses are morphologically and/or cytogenetically abnormal, some women appear to conceive abnormal embryos repeatedly. Most of these embryos, however, may be screened out prenatally and escape clinical detection. Information on prior reproductive history of the woman should be examined carefully in genetic counselling.

Developmental study of neural tube closure in a mouse stock with a high incidence of exencephaly

About 17% of embryos and fetuses in the SELH/Bc mouse stock have the anterior neural tube defect, exencephaly. No other malformations are seen. The genetic liability to exencephaly was shown to be probably genetically fixed in the SELH/Bc stock. This means that SELH/Bc embryos with successful neural tube closure are genetically the same as exencephalics. Females were significantly more likely to be affected than males (66% females). The pattern of morphological developmental events during anterior neural tube closure on days 8 and 9 of gestation was compared among 322 ICR/Bc (normal), 304 SWV/Bc (normal), and 265 SELH/Bc embryos. Anterior neural tube closure was found to follow a strikingly different pattern in almost all SELH/Bc embryos than in either of the normal strains or in previous published studies. SELH/Bc embryos lack the initial contact between the anterior folds in the posterior prosencephalon/anterior mesencephalon region (Closure 2). In spite of this, all but 17% manage to close the anterior neural tube by extending caudally the later occurring normal anterior zone of contact and fusion at the most rostral aspect of the prosencephalon (Closure 3) through the region of Closure 2 to meet the zone of closure of the rhombencephalon, Closure 4. Anterior neural tube closure was completed late, and in some SELH/Bc embryos, elevation and fusion in the mesencephalon did not occur at all. In histological sections of six- and eight-somite embryos, elevated numbers of pyknotic cells in the neuroepithelium and mesenchyme, and elevated numbers of unstained inclusions in the neuroepithelium were found; but their relationship, if any, to the abnormal pattern of neural tube closure is not clear.

Neural tube defects: considerations on the pathogenesis and correlation with myelodysplasia in man. I. Embryological aspects

In this first part, a brief review of some of the general embryological, pathogenetical and experimental aspects of neural tube defects is made. In particular, the importance of the extracellular matrix and glycosaminoglycans is discussed in relation with neural tube defects.

Neural tube defects: considerations on the pathogenesis and correlation with myelodysplasia in man. II. An experimental model

In this second part, the authors report the results obtained by evaluating the presence of glycosaminoglycans (GAGs) in the brain of rat fetuses with neural tube defects and hydrocephalus, secondary to the administration of trypan blue during pregnancy. A decrease in the GAG content was found. The authors hypothesize that this anomaly in GAG formation is responsible for both the neural tube defect and the associated malformations, namely hydrocephalus and hypoplasia of the posterior cranial fossa.

Neuroectodermal appendages: the human tail explained

The human tail has been intermittently described in the literature since the early 1900s. These have typically been isolated cases presented primarily with intrigue and medical curiosity. Presented here is a series of 6 neuroectodermal appendages with a proposal for their etiological development. The material presented will support a theory of the superficial extension of a dermal sinus tract in the formation of neuroectodermal appendages. These are characterized by: a posterior localization in or near the midline, a tubular or 'tail-like' appearance, extension of the appendage into the spinal canal with attachment to neural elements, variable vertebral defects and occasionally an associated appendage which may appear as either a separate entity (probably due to breakage during development) or in connection with the posterior appendage. The appropriate evaluation and treatment of this entity will also be discussed.

The cause of Chiari II malformation: a unified theory

The cause of the Chiari II hindbrain deformity in children born with a myelomeningocele can be explained by the lack of distention of the embryonic ventricular system. Defective occlusion and an open neural tube precludes the accumulation of fluid and pressure within the cranial vesicles. This distention is critical to normal brain development. The small posterior fossa, cerebral disorganization, and lückenschädel are the result.

Accumulation of basement membrane-associated hyaluronate is reduced in the posterior neuropore region of mutant (curly tail) mouse embryos developing spinal neural tube defects

We investigated the accumulation of newly synthesized glycoconjugates during spinal neurulation in mutant curly tail mouse embryos, a proportion of which develop lower spinal neural-tube defects (NTD). Embryos undergoing closure of the posterior neuropore (27- to 29-somite stage) were labeled in vitro with [3H]glucosamine, and [3H]glycoconjugates were analyzed by ion-exchange chromatography. Mutant embryos undergoing normal spinal neurulation exhibited a pattern of glycoconjugate accumulation closely similar to that observed for nonmutant embryos (Copp and Bernfield, 1988, Dev. Biol. 130, 573-582). Mutant embryos developing spinal NTD accumulated reduced amounts of [3H]hyaluronate specifically in the posterior neuropore region. Other embryonic regions and other glycoconjugates appeared unaffected by the developmental abnormality. Autoradiographic analysis of labeled curly tail embryos confirmed that [3H]hyaluronate accumulates in reduced amounts in the posterior neuropore region and indicated that this reduction is mainly localized to the site of developing basement membranes, beneath the neuroepithelium and around the notochord. Accumulation of [3H]hyaluronate in the interstitial mesenchymal matrix of the posterior neuropore region is not consistently affected in embryos developing spinal NTD. These results provide support for a role for basement-membrane hyaluronate in lower spinal neurulation.

A cell-type-specific abnormality of cell proliferation in mutant (curly tail) mouse embryos developing spinal neural tube defects

The mouse mutant curly tail (ct) provides a model system for studies of neurulation mechanisms. 60% of ct/ct embryos develop spinal neural tube defects (NTD) as a result of delayed neurulation at the posterior neuropore whereas the remaining 40% of embryos develop normally. In order to investigate the role of cell proliferation during mouse neurulation, cell cycle parameters were studied in curly tail embryos developing spinal NTD and in their normally developing litter-mates. Measurements were made of mitotic index, median length of S-phase and percent reduction of labelling index during a [3H]thymidine pulse-chase experiment. These independent measures of cell proliferation rate indicate a reduced rate of proliferation of gut endoderm and notochord cells in the neuropore region of embryos developing spinal NTD compared with normally developing controls. The incidence of cell death and the relative frequency of mitotic spindle orientations does not differ consistently between normal and abnormal embryos. These results suggest a mechanism of spinal NTD pathogenesis in curly tail embryos based on failure of normal cell proliferation in gut endoderm and notochord.

Origin of the dorsal surface of the neural tube by progressive delamination of epidermal ectoderm and neuroepithelium: implications for neurulation and neural tube defects

Knowledge of the morphogenetic events involved in the development of the dorsal portion of the neural tube is important for understanding neural tube closure, neural crest cell formation and emigration, and the origin of neural tube defects. Here, I characterize the progressive development of the tips of the neural folds during fold elevation in the trunk of mouse and chick embryos and the events leading to formation of the dorsal portion of the neural tube as the epidermal ectoderm (EE) and neuroepithelium (NE) separate from each other. The nature and timing of appearance of collagen IV, laminin and fibronectin were analysed by immunofluorescent and immunogold labelling, and ruthenium red and tannic acid were used to enhance staining for proteoglycans and glycosaminoglycans. As the neural folds elevate, the NE and EE delaminate progressively beginning at the basal surface of the lateral extremes of the neural plate. Nevertheless, the two epithelia remain connected across the zone of delamination by their previously existing basal laminae. In each fold, proteoglycan granules appear at the interface between the NE and EE before delamination begins, and then an (interepithelial) space begins to open and propagate dorsally. Other extracellular matrix (ECM) molecules appear within the space a short distance behind its tip and basal lamina deposition begins shortly thereafter. As fusion occurs, the interepithelial spaces of the two folds coalesce and the final separation of the EE from the NE is accomplished. These observations suggest that the previously recognized delay in deposition of ECM and basal lamina on the dorsal portion of the neural tube and on the overlying EE is a direct consequence of the delamination of the two epithelia and the establishment of two new basal surfaces. The observation that the surface of the dorsal third of the neural tube forms by delamination rather than by juxtaposition of previously existing basal surfaces of the two epithelial is discussed in terms of possible implications for models of neurulation and the origin of neural tube defects.

Somatomedin inhibitors from human serum produce abnormalities in mouse embryos in culture

Two human serum fractions, one from normal individuals (Mr 1,150-1,310 daltons) and the other (Mr 800-1,100 daltons) from patients suffering with uremia (renal failure, azotemia), were added to the medium used to grow embryos in whole-embryo culture (WEC) beginning at the 3-5 (day 9) or 18-21 (day 10) somite stage. Both of these fractions possessed somatomedin (insulin-like growth factor) inhibitory activity. Day 9 embryos exposed to either of the serum fractions for 24 hr exhibited incomplete rotation and neural tube closure defects and were smaller than control embryos (decreased total protein content). Developmental abnormalities induced in day 10 embryos following 24 hr in culture included a marked decrease in expansion of the brain regions, hypoplasia of the first two branchial arches, and decreased amounts of total protein compared to controls. The visceral yolk sacs (VYSs) of somatomedin inhibitor (SI)-exposed conceptuses were opaque, and those from day 10 conceptuses contained significantly more protein than controls. Morphologically, the VYS endoderm cells from SI-exposed embryos contained a much higher density of "vacuoles" than controls. These results mimic those produced by exposure of conceptuses to an SI of Mr800-1,100 obtained from the serum of diabetic rats and suggest that similar substances and mechanisms are involved.

Strain differences in the teratogenicity induced by sodium valproate in cultured mouse embryos

Strain differences in the teratogenicity of valproic acid (VPA) have been reported in mice. Finnell and Chernoff (Proc. Grnwd. Genet. Ctr. 5:162-163, 1985) showed that 300 mg/kg of VPA twice a day on days 6-8 of gestation induced exencephaly in 82% of SWV embryos but in 0% of C57BL/6J embryos. In the present experiment, we have collected similar results and investigated this strain difference using whole embryo culture in an attempt to determine whether maternal or embryonic factors are responsible for the difference. Mouse embryos were explanted on day 8.5 (plug day 0), and embryos at the 6-8-somite stage were cultured for 48 hours in rat serum containing various doses of sodium valproate (NaVP). All the embryos died within 24 hours with 4.5-mM and higher doses of NaVP in C57BL/6NCr1BR (C57) and with 3.0-mM and higher doses in SWV. Unfused brain folds were recognized in embryos treated with 3.0-mM and higher doses in C57, and with 1.0-mM and higher doses in SWV. Irregular somite formation was observed in many embryos treated with 1.6-mM and higher doses in C57 and with 1.0-mM and higher doses in SWV. These results indicate that SWV embryos have 1.5-3 times the sensitivity of C57 embryos to the embryolethal and teratogenic effects of NaVP. Furthermore, the results suggest that the basis of the strain difference resides within the embryo rather than the mother.

Basal lamina and extracellular matrix alterations in the caudal neural tube of the delayed Splotch embryo

Regional patterns of deposition of laminin (LN), fibronectin (FN), type IV collagen (IV), and heparan sulfate proteoglycan (HSPG) were examined during the formation of the caudal neural tube in embryos homozygous for the delayed Splotch gene and in their normal littermates. Delayed Splotch embryos had neural tube closure defects which extended from the posterior neuropore into the region formed by secondary neurulation. During posterior neuropore closure these components were normally restricted to forming basal laminae, with FN and HSPG additionally deposited in the mesenchyme. Unlike control embryos in which medial regions of the neuroepithelial basal lamina contained greatest amounts of all four, the dorsolateral zone contained less LN and IV and more FN and HSPG, in affected embryos these components were less densely deposited medially, reflecting perhaps the poor structural organization of the notochord. The neuroepithelial basal lamina was often disorganized and wavy compared to the linear pattern typical of controls. By the 12th day, the posterior neuropore of controls had closed and secondary neurulation was underway; however in delayed Splotch embryos, the neural folds remained widely splayed and epithelium newly formed via secondary neurulation extended that abnormally open configuration to the tip of the tailbud. In controls, with mesenchymal cell aggregation FN and HSPG were displaced from between cells to the forming basal lamina. As a central lumen formed within the aggregate LN and IV were added to the basal lamina, and the newly formed epithelium merged with the anterior neural tube. In delayed Splotch embryos, FN and HSPG were incompletely removed from aggregating cell surfaces, the normal morphogenetic cell shaping changes failed to occur and in many embryos a central lumen did not form; the overgrown, aggregated cells merging with the abnormally splayed anterior neural folds. In addition, the critical enrichment of FN and HSPG present between newly formed and consolidated neuroepithelium was displaced in delayed Splotch embryos.

Animal model: dysmorphogenesis and death in a chicken embryo model

The chicken embryo is a useful animal model for investigating problems in developmental biology and teratology. Here we report data that further define the causes of 2 different patterns of malformation (one associated with amnion abnormalities, the other with isolated neural tube defects) and death induced by making a window in the shell and subshell membranes during the first day of incubation. The interpretation of these data suggests to us the following hypotheses. An early amnion deficit spectrum or syndrome (EADS) in chicken embryos is caused by a brief (less than 10 sec) perturbation that occurs during the windowing procedure. This perturbation results in an acute increase in mechanical tension to the developing embryo and support structures, dehydration localized to the area of the blastoderm, and/or increased friction between the blastoderm and overlying vitelline and shell membranes. Isolated neural tube defects (NTDs) are caused by a longer perturbation (greater than 3 hr) consisting of increased mechanical stress across the blastoderm. The mechanical stress is associated with the introduction of a new air space over the animal pole of the yolk during windowing. The new air space causes the shape of the yolk to change (ie, to be deformed), resulting in an increase in mechanical tension across the vitelline membrane and blastoderm. NTDs involving the head are associated with significant early embryonic mortality, whereas those involving the trunk are not. Death may also be caused by cardiovascular anomalies observed in EADS. It is concluded that disturbances in morphogenesis and death in this model are, therefore, the result of extrinsic forces (eg, mechanical stress, localized dehydration, or friction) acting on different tissue types at various critical times in development. Intensity and duration of these forces on the developing blastoderm are important variables.

Vascular basis for neural tube defects: a hypothesis

A hypothesis is set forth that neural tube defects are produced by inadequate nutrient supply to the rapidly growing neural folds. According to this hypothesis, a delay in establishing blood flow or an aberration of blood supply to neural tissue may interfere with nutrition and prevent neural tube closure. The hypothesis was tested by examining the vasculature of fetuses with spinal neural tube defects. In each case, the arterial supply to the region of the neural tube defect was disturbed. Because development of arterial supply to the neural folds predates neural tube closure, these vascular abnormalities are considered to be primary malformations that lead to neural tube defects rather than secondary morphologic disturbances resulting from neural tube defects.

Relationship of early neural tube appearance to myeloschisis in a chick embryo model

Myeloschisis, a form of neural tube defect involving the spinal cord, was induced in chicks by creating a window in the eggshell of the fertilized egg at 26 h after placement in an incubator. The embryos were stained and photographed through the window at 48 to 60 h after commencement of incubation and the neural tube was determined to be normal, delayed, irregular, or abnormally open for the developmental stage of the embryo. The eggs were then reincubated until 14 days of age. At that time the chicks were determined to have normal spinal cords or myeloschisis by gross examination, dissection, and histology. The appearance of the neural tube at 48 to 60 h was then correlated with the appearance of the spinal cord at 14 days of age. It was determined that in the chick embryo model of myeloschisis induced by windowing, a normal neural tube at the time of neural tube closure results in a 2.3% incidence of myeloschisis, a widely open neural tube a 47% incidence of myeloschisis, an irregular neural tube a 37% incidence of myeloschisis, and delayed closure of the neural tube a 14% incidence of myeloschisis. Thus, no appearance of an early neural tube can be said to always correlate with myeloschisis or a normal outcome. Additionally, it appears that within a single model there may be multiple mechanisms of production of myeloschisis.

Neural tube defects: epidemiology, detection, and prevention

Neural tube defects are common congenital malformations of the central nervous system and include anencephaly, spina bifida, and encephalocele. Prenatal detection by amniotic fluid analysis of alpha-fetoprotein is possible in those women known to be at high risk for neural tube defects. Maternal serum screening for increased alpha-fetoprotein levels is now available nationally and has the potential to identify women who otherwise would not be known to be at risk. The epidemiology, detection, screening, and prevention of neural tube defects are discussed, and an explanation of alpha-fetoprotein and its use in screening is offered.

Neural tube defects. Some remarks on the possible role of glycosaminoglycans in the genesis of the dysraphic state, the anomaly in the configuration of the posterior cranial fossa, and hydrocephalus

Recent developments in the field of experimentally induced neural tube defects (NTD) indicate that specific substances, namely the glycosaminoglycans (GAGs) may play a role in the genesis of spinal malformations. The authors report the results obtained by evaluating the GAGs in rat fetuses with NTD, secondary to the administration of Trypan Blue during pregnancy. A characteristic decrease in GAGs formation in the spinal and cranial structures as well as in the subependymal regions of the brain was found in the malformed fetuses. The authors hypothesize that this anomaly in GAGs formation is responsible for both the NTD and the associated malformations, namely hydrocephalus and hypoplasia of the posterior cranial fossa.

Diplomyelia: caudal duplication of the neural tube in mice

Diplomyelia (duplication of the neural tube or spinal cord) was studied histologically in nine cases of T/+ mouse embryos at 10-15 days of gestation. Grüneberg investigated T/+ fetuses and interpreted the extra neural tube to be notochord, but a reexamination of this material demonstrated that the interpretation is incorrect. Diplomyelia is produced in the mutations Fused, Kinky, vestigial tail, homozygous Brachyury, and t-haplotype t9 and in the new mutation, NM 529, described here.

Neural tube defects: a review of human and animal studies on the etiology of neural tube defects

Although neural tube defects are a common congenital anomaly, their etiology is not known. Human studies have emphasized the pathology and epidemiology of the defects and suggest that in the majority of cases the etiology is multifactorial. Factors which appear possibly to be important are genetic predisposition, maternal illness, and fetal drug exposure. Animal studies have utilized naturally occurring neural tube defects and teratologically induced lesions. No animal model has been convincingly established as the equivalent of human neural tube defects. However, animal models have allowed investigation of the mechanisms of suggested human teratogens and determination of the pathogenesis of naturally occurring animal defects. Their most important contribution has been in furthering the understanding of the normal mechanisms of neural tube closure. It may be through this understanding that the etiology of human neural tube defects will be determined.

Ultrastructural analysis of chromosome translocation-induced neural tube defects

Neural tube closure defects occurred in 33% of the embryos obtained from matings of male mice heterozygous for a reciprocal chromosome translocation (T(2;4)1Sn) with normal female CFLP mice. Light and electron microscopic observations of neuroepithelium and mesenchyme in affected embryos indicated two distinct types of anomalies occurred. The first consisted of neuroepithelial hypertrophy and neural tube closure defects. These defects most frequently affected the midbrain and hindbrain, but occasional defects of the lumbosacral neural tube were also observed. Unlike the highly organized, pseudostratified neuroepithelium in control embryos, neuroepithelial cells became stratified and formed cell islands with secondary lumina within the wall of the neural tube. The second condition was associated with a reduction in neuroepithelial thickness, considerable neuroepithelial and neural crest cell death, basal lamina alterations and premature invasion of the neuroepithelium by subjacent endothelial cells. In both cases, the cephalic mesenchyme cells, rather than their normal stellate appearance, were markedly elongated in shape and reduced in area. The number of cell-cell contacts between mesenchymal cells was also reduced significantly. These results are discussed in light of recent theories regarding the role of mesenchyme and extracellular matrix in neurulation.

Methacrylic acid as a teratogen in rat embryo culture

Using day 10 rat embryos cultured in vitro, we have shown that methacrylic acid is teratogenic at concentrations ranging from 1.2 to 2.1 mM. At these concentrations, methacrylic acid produced concentration-dependent decreases in growth parameters, i.e., crown-rump length, number of somites, and embryo protein content. In addition, methacrylic acid exposure produced malformed embryos characterized primarily by abnormal neurulation. Less frequent abnormalities included hypoplasia of the prosencephalon, edema, malpositioned heart, abnormal flexion, and dilated otic vesicles. Accompanying these abnormalities was an underlying increase in methacrylic acid-induced cell death.

Transfer of valproic acid and its main active unsaturated metabolite to the gestational tissue: correlation with neural tube defect formation in the mouse

The pharmacokinetics of the antiepileptic drug valproic acid (2-propyl-pentanoic acid; VPA) and its main active metabolite 2-en-VPA (2-propyl-2-pentenoic acid) in mouse serum and gestational material were studied and correlated with the drastic differences between the two compounds in their embryotoxicity. The peak levels of VPA reached after 0.5 hours were only slightly higher than that of 2-en-VPA (both in mother and gestational material). The free concentrations of VPA and 2-en-VPA in maternal serum also peaked at 0.5 hours. After that time the free maternal serum levels of 2-en-VPA decreased much more rapidly than the concentrations in the gestational materials. The area under the concentration/time curves (AUC) values of 2-en-VPA in mother and embryo were lower than corresponding values of VPA; the higher clearance of 2-en-VPA was predominantly due to an increased volume of distribution. Since we have previously shown that the peak concentrations and not the AUC values of VPA correlated with the teratogenicity of this compound, our present data indicate that the low teratogenic and embryotoxic potential of 2-en-VPA is a result of the intrinsic activity of this compound and not of lower peak concentrations reached in mother and embryo.

Pathogenesis of neural dysraphism in the mouse mutant vacuolated lens (vl)

The pathogenesis and expression of caudal neural dysraphism were studied by means of tritiated thymidine autoradiography in the mouse mutant vacuolated lens (vl) at 11-13 days of gestation. In homozygous litters, all of the embryos microscopically exhibited spinal cord defects, even though dysraphism could be detected grossly only in the most severely affected ones. The defects ranged from extreme eversion of widely open neural folds to a dorsally expanded neurocoel with an attenuated or distorted roof plate. Incorporation of tritiated thymidine occurred in cells in the defective roof plates, in severely distorted areas of the neural tube where cellular disaggregation occurred, and in isolated areas within the developing intermediate layer, as well as in normal sites of cellular proliferation. The frequently observed central mass of distorted but proliferating neural tissue associated with bilateral attenuations of the roof plate suggests a failure of, or defect in, the normal process of apposition and fusion of the neural folds, rather than a failure in opposition. The range in severity and the gross and microscopic manifestations of neuropathological lesions in the homozygous vl embryos indicate that this heretofore unexplored mutant has considerable potential as an experimental model for analyzing the origins and mechanisms of human neural dysraphism.

Neural tube defects: heterogeneity and homogeneity

Detailed investigations were made on 150 fetuses with neural tube defects (NTD). After eliminating those with recognised causes, the rest were found to consist of fetuses with both isolated NTD and NTD with other developmental abnormalities. On evaluation of reproductive history, type and frequencies of NTD in pregnancies before conception, and sex of the fetuses involved, no demonstrable difference between these two types of NTD was found. Secondly, in those with additional developmental abnormalities, a significant clustering of developmental defects rather than a uniform distribution throughout abnormalities were found predominantly in cases of total craniorachischisis and upper thoracic spina bifida, less often in anencephaly and thoraco-lumbar spina bifida, and never in lumbo-sacral spina bifida. Thus it appears that there is not a random concurrence of other developmental abnormalities with NTD but a definite pattern. We suggest that this implies a connection between the developmental abnormality and the NTD and that the additional abnormalities arise due to mechanical induction by the particular specific disturbance of the neural tube and its surrounding tissues. The most important difference between isolated NTD and those with other associated abnormalities is that the disruption in development at neurulation is more far reaching in the latter than in the former.

Ultrastructural analysis of malformations of the embryonic neural axis induced by in vitro hyperglycemic conditions

Neural tube defects are the most common malformations associated with diabetic pregnancies. Although the teratogenic effects of excess glucose have been investigated in in vivo and in vivo studies, a cellular basis for neural tube defects has not been elucidated. We used rat embryo culture to study the organogenesis period of development, with excess d-glucose added to the serum medium to induce neural tube anomalies. Light and electron microscopic examination of control 12-day-old embryos grown 48 hours in culture revealed blastlike cells with few organelles or cellular processes. Twelve-day-old embryos cultured in excess d-glucose had advanced cellular maturation with differentiation, including the presence of free polysomes and copious cell processes, regardless of whether they had an open neural tube. Cytoarchitectural changes such as decreased numbers of mitotic figures with mitotic cells in the mantle layer were focally distributed throughout the neural epithelium but with predominance at the site of failed closure. In vivo studies failed to demonstrate neural processes in day 12 normal embryos. Fourteen-day-old embryos grown in utero also had foci of cell processes in the neural tube but to a much lesser degree than that observed in the in vitro day 12 glucose-exposed embryos. The cellular aberrations in the excess d-glucose-treated embryos are characteristic of a premature maturational change. Since they are present in excess d-glucose-exposed embryos with or without failure of neural tube closure, these maturational and cytoarchitectural changes may contribute to the cellular basis for neural tube defects.

Effects of mid-trimester induced abortion on the subsequent pregnancy

The outcome of the pregnancy following (a) a mid-trimester termination of pregnancy (TOP) for fetal neural tube defect (NTD) (77 women = group 1); (b) mid-trimester TOP for fetal Down's syndrome (13 women = group 2); (c) delivery of a baby with NTD (119 women = group 3) was studied. The prenatal fetal loss was relatively high in all groups. In group 1 it was similar to that found in other studies after first trimester TOP, in group 2 it was associated with advanced maternal age and the unexpected finding in group 3 was not attributable to advanced maternal age. It is suggested that a previous NTD per se might increase the risk of fetal loss in the next pregnancy. A previous mid-trimester TOP for NTD was not associated with an increase in premature labour, small for dates babies or congenital abnormality in the next pregnancy, but there was a slight increase in the number of babies weighing less than 2500 g.

A review of the theories of vertebrate neurulation and their relationship to the mechanics of neural tube birth defects

All of the published theories of neurulation, (some of them forgotten but never disproved), are reviewed for the purpose of assessing just where we are in coming to a satisfactory explanation of this critical step in the formation of the brain and spinal cord, whose occasional failure leads to neural tube birth defects. A new approach to evaluating these theories is introduced, namely finite element analysis, along with a discussion of its promise and present limitations.

Relationship between timing of posterior neuropore closure and development of spinal neural tube defects in mutant (curly tail) and normal mouse embryos in culture

The relationship between timing of closure of the posterior neuropore (PNP) and development of spinal neural tube defects (NTD) has been studied in individual mutant curly tail mouse embryos maintained in culture. Moderate delay in PNP closure results in development of tail flexion defects whereas extreme delay of PNP closure is associated with development of open NTD. Experimental enlargement of the PNP at the stage of 25 to 29 somites leads to delayed PNP closure and development of tail flexion defects in 36% and 38% respectively of non-mutant A/Strong embryos. In curly tail embryos, the effect of experimental enlargement of the PNP summates with the genetic predisposition to produce an increased incidence of spinal NTD among which open defects are proportionately more common. These results indicate that a causal relationship exists between delay in PNP closure and development of spinal NTD in mouse embryos. The method described for distinguishing between prospective normal and abnormal curly tail embryos at a stage prior to the appearance of malformations provides an opportunity to study the morphogenetic processes that precede the development of genetically determined spinal NTD.

The role of microfilaments in cranial neurulation in rat embryos: effects of short-term exposure to cytochalasin D

During the late stages of cranial neurulation in mammalian embryos, the neural epithelium becomes concave. A thick subapical band of microfilament bundles, attached to junctions which are both vertical and horizontal in orientation, can be seen by TEM. Prior to this the neural epithelium is first biconvex and then V-shaped in transverse section, microfilament bundles are absent, and the subapical junctions are only vertical in orientation. In order to determine the role of microfilaments in cranial neurulation, rat embryos were exposed to cytochalasin D (0.15 micrograms ml-1) for 1 h at three stages of development: convex neural fold stage, early concave (prior to midline apposition at the forebrain/midbrain junction: 'preapposition') and later concave ('postapposition'). They were subsequently washed and cultured in addition-free medium for 5, 12, 24 or 36 h, then examined alive and by LM, TEM, or SEM. The degree of neural fold collapse varied with the stage of development: at the convex stage there was only slight opening out of the neural groove; early concave (preapposition) neural folds collapsed laterally to a horizontal position; later concave (postapposition) neural folds showed widening of the midbrain/hindbrain neuropore and slight neuroepithelial eversion at the anterior neuropore. Neural epithelium which had been concave prior to cytochalasin D treatment changed in structure so that the cells were broader and shorter; most of the subapical junctions were vertical in orientation, and microfilament bundles were represented either as a mass of amorphous material adjacent to the junctions, or as separated and broken filaments. Re-elevation of neural folds in 'recovery' cultures was accompanied by regeneration of apical microfilament bundles and horizontal junctions. Embryos which had been exposed to cytochalasin D at the convex or later concave stage of cranial neural fold development were able to complete cranial neural tube closure; none of the early-concave-stage embryos achieved apposition at the forebrain/midbrain junction, and all had major cranial neural tube defects. The results suggest that contraction of apical microfilament bundles plays an essential role in elevation of the neural folds and in the generation of concave curvature during the later stages of cranial neurulation. During the convex neural fold stage, microfilaments are important in maintaining neuroepithelial apposition in the neural groove, but are not crucial to maintenance of the convex shape. Successful formation and maintenance of the forebrain/midbrain apposition point at the appropriate time is considered to be essential for subsequent brain tube closure.

Ultrastructural changes in the neural tube of 10-day-old mouse embryos exposed to colchicine and hydroxyurea

The ultrastructural changes in the neural tube of 10-day-old mouse embryos were investigated between 1.5 hr and 4 hr after application of either 1 mg/kg colchicine (Col) or 500 mg/kg hydroxyurea (HU) or simultaneous application of both substances. During the investigated period, the shape of the nuclei of the neuroepithelial cells had changed from elongated to round after Col application. The chromatin in the nuclei was condensed and arranged in clusters. A breakdown of polysomes into ribosomes and an enlargement of the rough ER was observed in the cytoplasm. At the luminal surface, bleb-like cytoplasmic processes of the neuroepithelial cells containing monoribosomes protruded into the lumen. No cell necroses were visible in the neural tube after Col application. A condensation of chromatin in the nuclei of some neuroepithelial cells was visible 1.5 hr after HU application. Shortly thereafter, cell necroses appeared in the neural tube and 4 hr after HU application the entire spinal cord was strongly damaged. After simultaneous application of Col and HU, the ultrastructural changes in the neuroepithelial cells of the neural tube did not differ from the results obtained after Col application alone. In contrast to the results obtained after HU application alone, no necroses occurred after simultaneous application of Col and HU.

Ultrastructure of the neural basal lamina in loop-tail mice

Ultrastructural features of the neural basal lamina were studied by means of the tannic acid and ruthenium red techniques in normal and abnormal dysraphic loop-tail mice at 9-11 days of gestation. With ruthenium red, the configuration of the neural basal lamina is similar in both normal and abnormal embryos at 9-11 days. However, differences were detected in the abnormal 9-day embryos processed with tannic acid, as compared with normal littermates. These include irregularities in the lamina rara externa, as well as differences in the staining pattern of the neuroepithelial cell plasma membrane. By 11 days of gestation, the lamina rara externa of the normal embryos shows features similar to those observed in the 9-day abnormal embryos.

Lateral congenital spinal dermal sinus. A new clinical entity

Two children with spinal dermal sinuses of congenital origin are described. They are unusual because the skin dimples were located off the midline at the gluteal region.